EP3146909A1 - Chirurgische klammerversteifung mit magnetischen elementen - Google Patents
Chirurgische klammerversteifung mit magnetischen elementen Download PDFInfo
- Publication number
- EP3146909A1 EP3146909A1 EP16190430.5A EP16190430A EP3146909A1 EP 3146909 A1 EP3146909 A1 EP 3146909A1 EP 16190430 A EP16190430 A EP 16190430A EP 3146909 A1 EP3146909 A1 EP 3146909A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- staples
- anvil
- tissue
- buttress
- staple
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
- 230000005291 magnetic effect Effects 0.000 title claims abstract description 43
- 239000012636 effector Substances 0.000 claims abstract description 19
- 230000007246 mechanism Effects 0.000 claims abstract description 13
- 230000004044 response Effects 0.000 claims abstract description 12
- 239000003302 ferromagnetic material Substances 0.000 claims description 13
- 238000004891 communication Methods 0.000 claims description 5
- 230000004913 activation Effects 0.000 abstract description 11
- 210000001072 colon Anatomy 0.000 description 79
- 210000001035 gastrointestinal tract Anatomy 0.000 description 40
- 238000000034 method Methods 0.000 description 27
- 230000003872 anastomosis Effects 0.000 description 25
- 238000010304 firing Methods 0.000 description 13
- 238000005516 engineering process Methods 0.000 description 11
- 238000001356 surgical procedure Methods 0.000 description 11
- 210000003484 anatomy Anatomy 0.000 description 9
- 230000003874 surgical anastomosis Effects 0.000 description 9
- 230000005294 ferromagnetic effect Effects 0.000 description 8
- 239000000463 material Substances 0.000 description 6
- 210000000664 rectum Anatomy 0.000 description 6
- 238000003491 array Methods 0.000 description 5
- 230000000295 complement effect Effects 0.000 description 4
- 230000005855 radiation Effects 0.000 description 4
- 238000004140 cleaning Methods 0.000 description 3
- 230000014509 gene expression Effects 0.000 description 3
- 238000012986 modification Methods 0.000 description 3
- 230000004048 modification Effects 0.000 description 3
- 238000013519 translation Methods 0.000 description 3
- CWYNVVGOOAEACU-UHFFFAOYSA-N Fe2+ Chemical compound [Fe+2] CWYNVVGOOAEACU-UHFFFAOYSA-N 0.000 description 2
- XEEYBQQBJWHFJM-UHFFFAOYSA-N Iron Chemical compound [Fe] XEEYBQQBJWHFJM-UHFFFAOYSA-N 0.000 description 2
- PXHVJJICTQNCMI-UHFFFAOYSA-N Nickel Chemical compound [Ni] PXHVJJICTQNCMI-UHFFFAOYSA-N 0.000 description 2
- 229910045601 alloy Inorganic materials 0.000 description 2
- 239000000956 alloy Substances 0.000 description 2
- 230000008878 coupling Effects 0.000 description 2
- 238000010168 coupling process Methods 0.000 description 2
- 238000005859 coupling reaction Methods 0.000 description 2
- 230000007774 longterm Effects 0.000 description 2
- 238000012546 transfer Methods 0.000 description 2
- 238000011282 treatment Methods 0.000 description 2
- 241000894006 Bacteria Species 0.000 description 1
- 229910000684 Cobalt-chrome Inorganic materials 0.000 description 1
- IAYPIBMASNFSPL-UHFFFAOYSA-N Ethylene oxide Chemical compound C1CO1 IAYPIBMASNFSPL-UHFFFAOYSA-N 0.000 description 1
- 229910052779 Neodymium Inorganic materials 0.000 description 1
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 1
- 239000004775 Tyvek Substances 0.000 description 1
- 229920000690 Tyvek Polymers 0.000 description 1
- WAIPAZQMEIHHTJ-UHFFFAOYSA-N [Cr].[Co] Chemical compound [Cr].[Co] WAIPAZQMEIHHTJ-UHFFFAOYSA-N 0.000 description 1
- 230000006978 adaptation Effects 0.000 description 1
- 239000000853 adhesive Substances 0.000 description 1
- 230000001070 adhesive effect Effects 0.000 description 1
- 230000005540 biological transmission Effects 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- KPLQYGBQNPPQGA-UHFFFAOYSA-N cobalt samarium Chemical compound [Co].[Sm] KPLQYGBQNPPQGA-UHFFFAOYSA-N 0.000 description 1
- 239000010952 cobalt-chrome Substances 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 230000010339 dilation Effects 0.000 description 1
- 210000003238 esophagus Anatomy 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 230000000977 initiatory effect Effects 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 229910052742 iron Inorganic materials 0.000 description 1
- 238000002955 isolation Methods 0.000 description 1
- 239000000696 magnetic material Substances 0.000 description 1
- QEFYFXOXNSNQGX-UHFFFAOYSA-N neodymium atom Chemical compound [Nd] QEFYFXOXNSNQGX-UHFFFAOYSA-N 0.000 description 1
- 229910052759 nickel Inorganic materials 0.000 description 1
- 239000006187 pill Substances 0.000 description 1
- 230000002265 prevention Effects 0.000 description 1
- 229910052761 rare earth metal Inorganic materials 0.000 description 1
- 150000002910 rare earth metals Chemical class 0.000 description 1
- 230000002441 reversible effect Effects 0.000 description 1
- 229910000938 samarium–cobalt magnet Inorganic materials 0.000 description 1
- 230000006641 stabilisation Effects 0.000 description 1
- 238000011105 stabilization Methods 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 230000001954 sterilising effect Effects 0.000 description 1
- 238000004659 sterilization and disinfection Methods 0.000 description 1
- 210000000115 thoracic cavity Anatomy 0.000 description 1
- 239000010936 titanium Substances 0.000 description 1
- 229910052719 titanium Inorganic materials 0.000 description 1
- 230000007704 transition Effects 0.000 description 1
- 210000001835 viscera Anatomy 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
- A61B17/105—Wound clamp magazines
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07292—Reinforcements for staple line, e.g. pledgets
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00876—Material properties magnetic
Definitions
- portions of a patient's digestive tract may be cut and removed to eliminate undesirable tissue or for other reasons.
- portions of the digestive tract may be coupled together in an end-to-end anastomosis.
- the end-to-end anastomosis may provide a substantially unobstructed flow path from one portion of the digestive tract to the other portion of the digestive tract, without also providing any kind of leaking at the site of the anastomosis.
- an instrument that may be used to provide an end-to-end anastomosis is a circular stapler.
- Some such staplers are operable to clamp down on layers of tissue, cut through the clamped layers of tissue, and drive staples through the clamped layers of tissue to substantially seal the layers of tissue together near the severed ends of the tissue layers, thereby joining the two severed ends of the anatomical lumen together.
- the circular stapler may be configured to sever the tissue and seal the tissue substantially simultaneously.
- the circular stapler may sever excess tissue that is interior to an annular array of staples at an anastomosis, to provide a substantially smooth transition between the anatomical lumen sections that are joined at the anastomosis.
- Circular staplers may be used in open procedures or in endoscopic procedures. In some instances, a portion of the circular stapler is inserted through a patient's naturally occurring orifice.
- Some circular staplers may include a motorized actuation mechanism. Examples of circular staplers with motorized actuation mechanisms are described in U.S. Pub. No. 2015/0083772 , entitled “Surgical Stapler with Rotary Cam Drive and Return,” published March 26, 2015; U.S. Pub. No. 2015/0083773 , entitled “Surgical Stapling Instrument with Drive Assembly Having Toggle Features," published March 26, 2015; U.S. Pub. No. 2015/0083774 , entitled “Control Features for Motorized Surgical Stapling Instrument,” published March 26, 2015; and U.S. Pub. No. 2015/0083775 , entitled “Surgical Stapler with Rotary Cam Drive,” published March 26, 2015.
- FIGS. 1-2 depict an exemplary surgical circular stapling instrument (10) that may be used to provide an end-to-end anastomosis between two sections of an anatomical lumen such as a portion of a patient's digestive tract.
- Instrument (10) of this example comprises a handle assembly (100), a shaft assembly (200), a stapling head assembly (300), an anvil (400), and a removable battery pack (120). Each of these components will be described in greater detail below. It should be understood that, in addition to or in lieu of the following, instrument (10) may be further constructed and operable in accordance with at least some of the teachings of U.S. Patent App. No.
- anvil (400) of the present example comprises a head (410) and a shank (420).
- Head (410) includes a proximal surface (412) that defines a plurality of staple forming pockets (414).
- Staple forming pockets (414) are arranged in two concentric annular arrays in the present example.
- Staple forming pockets (414) are configured to deform staples as the staples are driven into staple forming pockets (414) (e.g., deforming a generally "U" shaped staple into a "B" shape as is known in the art).
- Shank (420) defines a bore or lumen (422) and includes a pair of pivoting latch members (430) positioned in bore (422).
- Each latch member (430) includes features that allows anvil (400) to be removably secured to a trocar (330) of stapling head assembly (300) as will be described in greater detail below. It should be understood, however, that anvil (400) may be removably secured to a trocar (330) using any other suitable components, features, or techniques.
- Stapling head assembly (300) is located at the distal end of shaft assembly (200). As shown in FIGS. 1-2 , anvil (400) is configured to removably couple with shaft assembly (200), adjacent to stapling head assembly (300). As will be described in greater detail below, anvil (400) and stapling head assembly (300) are configured to cooperate to manipulate tissue in three ways, including clamping the tissue, cutting the tissue, and stapling the tissue. As best seen in FIGS. 4-5 , stapling head assembly (300) of the present example comprises a tubular casing (310) housing a slidable staple driver member (350). A cylindraceous inner core member (312) extends distally within tubular casing (310). Tubular casing (310) is fixedly secured to an outer sheath (210) of shaft assembly (200), such that tubular casing (310) serves as a mechanical ground for stapling head assembly (300).
- Trocar (330) is positioned coaxially within inner core member (312) of tubular casing (310). Trocar (330) is operable to translate distally and proximally relative to tubular casing (310) in response to rotation of a knob (130) located at the proximal end of handle assembly (100).
- Trocar (330) comprises a shaft (332) and a head (334). Head (334) includes a pointed tip (336) and an inwardly extending proximal surface (338). Head (334) and the distal portion of shaft (332) are configured for insertion in bore (422) of anvil (420). Proximal surface (338) is configured to complement features of latch members (430) to provide a snap fit between anvil (400) and trocar (330).
- Staple driver member (350) is operable to actuate longitudinally within tubular casing (310) in response to activation of motor (160) as will be described in greater detail below.
- Staple driver member (350) includes two distally presented concentric annular arrays of staple drivers (352).
- Staple drivers (352) are arranged to correspond with the arrangement of staple forming pockets (414) described above.
- each staple driver (352) is configured to drive a corresponding staple into a corresponding staple forming pocket (414) when stapling head assembly (300) is actuated.
- Staple driver member (350) also defines a bore (354) that is configured to coaxially receive core member (312) of tubular casing (310).
- Knife member (340) is coaxially positioned within staple driver member (350).
- Knife member (340) includes a distally presented, sharp circular cutting edge (342).
- Knife member (340) is sized such that knife member (340) defines an outer diameter that is smaller than the diameter defined by the inner annular array of staple drivers (352).
- Knife member (340) also defines an opening that is configured to coaxially receive core member (312) of tubular casing (310).
- a deck member (320) is fixedly secured to tubular casing (310).
- Deck member (320) includes a distally presented deck surface (322) defining two concentric annular arrays of staple openings (324).
- Staple openings (324) are arranged to correspond with the arrangement of staple drivers (352) and staple forming pockets (414) described above.
- each staple opening (324) is configured to provide a path for a corresponding staple driver (352) to drive a corresponding staple through deck member (320) and into a corresponding staple forming pocket (414) when stapling head assembly (300) is actuated.
- the arrangement of staple openings (322) may be modified just like the arrangement of staple forming pockets (414) as described above.
- Deck member (320) defines an inner diameter that is just slightly larger than the outer diameter defined by knife member (340). Deck member (320) is thus configured to allow knife member (340) to translate distally to a point where cutting edge (342) is distal to deck surface (322).
- FIG. 6 shows various components of shaft assembly (200), which extends distally from handle assembly (100) and couples components of stapling head assembly (300) with components of handle assembly (100).
- shaft assembly (200) includes an outer sheath (210) that extends between handle assembly (100) and tubular casing (310).
- outer sheath (210) is rigid and includes a preformed curved section that is configured to facilitate positioning of stapling head assembly (300) within a patient's colon.
- Shaft assembly (200) further includes a trocar actuation rod (220) and a trocar actuation band assembly (230).
- the distal end of trocar actuation band assembly (230) is fixedly secured to the proximal end of trocar shaft (332).
- the proximal end of trocar actuation band assembly (230) is fixedly secured to the distal end of trocar actuation rod (220), such that trocar (330) will translate longitudinally relative to outer sheath (210) in response to translation of trocar actuation band assembly (230) and trocar actuation rod (220) relative to outer sheath (210).
- Trocar actuation band assembly (230) is configured to flex such that trocar actuation band assembly (230) may follow along the preformed curve in shaft assembly (200) as trocar actuation band assembly (230) is translated longitudinally relative to outer sheath (210).
- trocar actuation band assembly (230) has sufficient column strength and tensile strength to transfer distal and proximal forces from trocar actuation rod (220) to trocar shaft (332).
- Trocar actuation rod (220) is rigid.
- a clip (222) is fixedly secured to trocar actuation rod (220) and is configured to cooperate with complementary features within handle assembly (100) to prevent trocar actuation rod (220) from rotating within handle assembly (100) while still permitting trocar actuation rod (220) to translate longitudinally within handle assembly (100).
- Trocar actuation rod (220) further includes a coarse helical threading (224) and a fine helical threading (226).
- Shaft assembly (200) further includes a stapling head assembly driver (240) that is slidably received within outer sheath (210).
- the distal end of stapling head assembly driver (240) is fixedly secured to the proximal end of staple driver member (350).
- the proximal end of stapling head assembly driver (240) is secured to a drive bracket (250) via a pin (242). It should therefore be understood that staple driver member (350) will translate longitudinally relative to outer sheath (210) in response to translation of stapling head assembly driver (240) and drive bracket (250) relative to outer sheath (210).
- Stapling head assembly driver (240) is configured to flex such that stapling head assembly driver (240) may follow along the preformed curve in shaft assembly (200) as stapling head assembly driver (240) is translated longitudinally relative to outer sheath (210). However, stapling head assembly driver (240) has sufficient column strength to transfer distal forces from drive bracket (250) to staple driver member (350).
- handle assembly (100) includes a pistol grip (112) and several components that are operable to actuate anvil (400) and stapling head assembly (300).
- handle assembly (100) includes knob (130), a safety trigger (140) a firing trigger (150), a motor (160), and a motor activation module (180).
- Knob (130) is coupled with trocar actuation rod (220) via a nut (not shown), such that coarse helical threading (224) will selectively engage a thread engagement feature within the interior of the nut; and such that fine helical threading (226) will selectively engage a thread engagement feature within the interior of knob (130).
- These complementary structures are configured such that trocar actuation rod (220) will first translate proximally at a relatively slow rate, then translate proximally at a relatively fast rate, in response to rotation of knob (130).
- knob (130) when anvil (400) is coupled with trocar (330), rotation of knob (130) will provide corresponding translation of anvil relative to stapling head assembly (300). It should also be understood that knob (130) may be rotated in a first angular direction (e.g., clockwise) to retract anvil (400) toward stapling head assembly (300); and in a second angular direction (e.g., counterclockwise) to advance anvil (500) away from stapling head assembly (300). Knob (130) may thus be used to adjust the gap distance between opposing surfaces (412,322) of anvil (400) and stapling head assembly (300) until a suitable gap distance has been achieved.
- first angular direction e.g., clockwise
- a second angular direction e.g., counterclockwise
- Firing trigger (150) is operable to activate motor (160) to thereby actuate stapling head assembly (300).
- Safety trigger (140) is operable to selectively block actuation of firing trigger (150) based on the longitudinal position of anvil (400) in relation to stapling head assembly (300).
- Handle assembly (100) also includes components that are operable to selectively lock out both triggers (140, 150) based on the position of anvil (400) relative to stapling head assembly (300). When triggers (140, 150) are locked out, firing trigger (150) is prevented from initiating actuation of stapling head assembly (300).
- trigger (150) is only operable to initiate actuation of stapling head assembly (300) when the position of anvil (400) relative to stapling head assembly (300) is within a predefined range.
- firing trigger (150) of the present example includes an integral actuation paddle, such as the paddle shown and described in U.S. Patent App. No. 14/751,231 , entitled “Surgical Stapler with Reversible Motor,” filed June 26, 2015.
- the paddle is configured to actuate a switch of motor activation module (180) ( FIG. 1 ) when firing trigger (150) is pivoted to a fired position.
- Motor activation module (180) is in communication with battery pack (120) and motor (160), such that motor activation module (180) is configured to provide activation of motor (160) with electrical power from battery pack (120) in response to the paddle actuating the switch of motor activation module (180).
- motor (160) will be activated when firing trigger (150) is pivoted. This activation of motor (160) will actuate stapling head assembly (300) as described in greater detail below.
- Battery pack (120) is operable to provide electrical power to a motor (160) as noted above.
- Battery pack (120) may be removably coupled with handle assembly (100) through a snap fit or in any other suitable fashion.
- battery pack (120) and handle assembly (100) may have complementary electrical contacts, pins and sockets, and/or other features that provide paths for electrical communication from battery pack (120) to electrically powered components in handle assembly (100) when battery pack (120) is coupled with handle assembly (100).
- battery pack (120) is unitarily incorporated within handle assembly (100) such that battery back (120) cannot be removed from handle assembly (100).
- FIGS. 7-10 show an exemplary surgical procedure for providing a surgical anastomosis using instrument (10).
- an anastomosis may be performed to remove a section of a patient's gastrointestinal (GI) tract.
- GI gastrointestinal
- multiple portions of a patient's colon are severed and stapled to resect a diseased portion (C') of the colon (C).
- C' diseased portion
- the remaining severed and stapled portions of colon (C) are then anastomosed together, as discussed in further detail below.
- endocutter staplers (1000) may be inserted into a patient to sever and staple portions of the patient's colon (C).
- endocutter staplers (1000) may be constructed and operable in accordance with at least some of the teachings of U.S. Pat. No. 4,805,823 , entitled “Pocket Configuration for Internal Organ Staplers,” issued February 21, 1989; U.S. Pat. No. 5,415,334 , entitled “Surgical Stapler and Staple Cartridge,” issued May 16, 1995; U.S. Pat. No. 5,465,895 , entitled “Surgical Stapler Instrument,” issued November 14, 1995; U.S. Pat. No.
- Endocutter staplers (1000) are inserted into the body laparoscopically via respective trocars.
- Endocutter stapler (1000) comprises a shaft (1120) and an end effector (1110) extending from the shaft (1120).
- End effector (1110) comprises a first jaw (1112) and a second jaw (1114).
- First jaw (1112) comprises a staple cartridge (1140).
- Staple cartridge (1140) is insertable into and removable from first jaw (1112), though some variations may provide a staple cartridge that is not removable from (or at least readily replaceable from) first jaw (1112).
- Second jaw (1114) comprises an anvil (1130) that is configured to deform staples ejected from staple cartridge (1140).
- Second jaw (1114) is pivotable relative to first jaw (1112), though some variations pay provide first jaw (1112) as being pivotable relative to the second jaw (1114).
- Endocutter staplers (1000) may be configured ad operable in accordance with at least some of the teachings of U.S. Pub. No. 2013/0168435 , entitled “Surgical Stapling Instrument with an Articulatable End Effector,” published July 4, 2013. While end effector (1110) is straight and is thus configured to apply a straight line of staples (185) in the present example, in other examples end effector (1110) may be curved and may thus apply a curved line of staples (185).
- Anvil (1130) of endocutter stapler (1000) can be opened such that anvil (1130) and staple cartridge (1140) of endocutter stapler (1000) are positioned relative to the patient's colon (C).
- anvil (1130) is moved into a closed position, anvil (1130) clamps the colon (C) against staple cartridge (1140).
- endocutter stapler (1000) can be operated to sever and staple the colon (C) at a first, or upper, location.
- three linear rows of staples (185) are implanted on the upper side of the severed upper portion (UC) of colon (C) and three rows of the staples (185) are implanted in the adjacent region of the diseased portion (C') of the colon (C).
- the same endocutter stapler (1000) if reloaded with another cartridge (1140)), or another endocutter stapler (1000), can be operated to sever and staple the colon (C) at a second, or lower, location.
- three linear rows of staples (285) implanted on the lower side of the severed lower portion (LC) of the colon (C) and three rows of staples (285) are implanted in the adjacent region of the diseased portion (C') of the colon (C).
- other suitable configurations of staples may be implanted onto the upper portion (UC) and/or the lower portion (LC) of the colon (C).
- circular stapler (10) may be utilized to anastomose the upper portion (UC) and the lower portion (LC) of the colon (C).
- An operator inserts a portion of shaft (210) and stapling head assembly (300) into the rectum (R) of the patient into the lower portion (LC) of the colon (C).
- a user then inserts trocar (330) through the rows of staples (285).
- Trocar (330) of circular stapler (10) may then be positioned in the upper portion of the colon C.
- the sidewall of the upper portion of the colon C can be incised and trocar (330) can then be positioned inside the upper portion.
- Anvil (400) may then be directed into the upper portion of the colon (C) and connected to trocar (330) in the manner discussed above and as shown in FIG. 8 .
- knob (130) may be rotated in a first angular direction (e.g., clockwise) to retract anvil (400) toward stapling head assembly (300); and in a second angular direction (e.g., counterclockwise) to advance anvil (400) away from stapling head assembly (300).
- Knob (130) may thus be used to adjust the gap distance between opposing surfaces of anvil (400) and stapling head assembly (300) until a suitable gap distance has been achieved, such as in the manner discussed in U.S. Patent App. No. 14/751,506 .
- flap regions (FR) are formed in the lower portion (LC) of the colon (C) as anvil (400) is drawn toward stapling head assembly (300). These flap regions (FR) extend outwardly from the region of tissue compressed between anvil (400) and stapling head assembly (300).
- stapling head assembly (300) is configured to apply annular arrays of staples (385) in the tissue captured between anvil (400) and stapling head assembly (300).
- Knife member (340) is advanced toward anvil (440) to sever the tissue positioned radially inwardly with respect to the annular arrays of staples (385) applied by circular stapling instrument (10).
- anvil (400) and stapling head assembly (300) may together be withdrawn from the patient's rectum (R).
- the incision that was used to insert anvil (400) into the upper portion (UC) of the colon (C) may be closed via suturing or using any other suitable technique.
- the upper portion (UC) of the colon (C) and the lower portion (LC) of the colon (C) are held together by the annular array of staples (385) deployed by circular stapling instrument (10).
- the deployed annular array of staples (385) forms an anastomosis (A) that allows fluid tight communication from the upper portion (UC) of the colon (C) to the lower portion (LC) of the colon (C).
- Some of staples (285) that were deployed by endocutter stapler (1000) will be removed with the tissue that was transected by knife member (340) during actuation of stapling head assembly (300).
- staples (385) that were deployed by circular stapling instrument (10) may overlap with at least some of staples (285) that were deployed by endocutter stapler (1000) in the procedure described above with reference to FIGS. 7-10 . Such overlap may prevent proper formation of staples (385), which may compromise the integrity of anastomosis (A) in the long term.
- at least some of staples (285) that were deployed by endocutter stapler (1000) may interfere with compression of tissue between anvil (400) and deck member (320) and/or the traversal of knife member (340) through the tissue, which may also compromise the integrity of anastomosis (A) in the long term.
- FIG. 11 shows an exemplary alternative staple cartridge (510) that may be inserted into first jaw (1112) of end effector (1110) and used during the act of separating the diseased portion (C') of the colon (C) from the lower portion (LC) of the colon (C) as described above with reference to FIG. 7 .
- Staple cartridge (510) is substantially similar to staple cartridge (1140), except for that staple cartridge (510) includes two rows of staple cavities (545) on each side of slot (560) of instead of three rows. Therefore, when staple cartridge (510) is incorporated into endocutter stapler (1000), two rows of staples (585) are implanted onto opposing, severed portions of tissue rather than three rows of staples (585).
- Staple cartridge (510) of the present example further includes a buttress (550) that is secured to deck (570).
- Buttress (550) comprises a buttress body (560) with outer magnets (552a) and inner magnets (552b).
- buttress body (560) may be formed by a mesh of woven material that is provided in the form of a thin sheet.
- buttress (550) is removably adhered to deck (570), but in other examples buttress (550) may be associated with or coupled to cartridge (540) in a different manner (e.g., via clips, via hook and loop fasteners, etc.).
- end effector (1110) that incorporates staple cartridge (510) is actuated, buttress (550) will be severed along slot (560) and stapled onto tissue along with staples (585), as shown best in FIG. 12 .
- magnets (552a, 552b) are coupled to and positioned to rest atop buttress body (580) (e.g., facing anvil (1130)). In other examples, however, magnets (552a, 552b) may be otherwise coupled to buttress body (580), such as below buttress body (580) (e.g., facing cartridge deck (570)), or may be embedded within buttress body (580). Magnets (552a, 552b) are adhered to buttress body (580) in the present example, but in other examples magnets (552a, 552b) may be coupled to buttress (550) in some other fashion (e.g., positioned between two apposed layers of material that form buttress body (580)). In the present example, magnets (552a, 552b) are shown to be permanent pill magnets with a circular shape. Of course, magnets (552a, 552b) may instead have any other suitable shape.
- Each magnet (552a) is configured to be attracted to an adjacent magnet (552b), as shown in FIG. 12 and as will be discussed in further detail below.
- magnets (552a) are each oriented such that their north pole is facing deck (570) while magnets (552b) are each oriented such that their south pole is facing deck (570).
- end effector (1110) is configured such that magnets (552a, 552b) will not come into proximity to ferrous material.
- anvil (1130) may be formed of a non-ferrous material such that magnets (552a, 552b) will not be attracted to anvil (1130).
- FIGS. 14A-14C show steps an anastomosis procedure similar to the procedure shown in FIGS. 7-10 .
- the upper colon portion (UC) and the lower colon portion (LC) are shown to have been severed and stapled in a similar manner to that shown in FIGS. 7-8 .
- the lower colon portion (LC) has been severed and stapled utilizing staple cartridge (510).
- the lower colon portion (LC) therefore includes staples (585) and buttress (550) coupled thereto in the manner discussed above.
- a portion of shaft (210) and stapling head assembly (300) are inserted into the rectum (R) of the patient and into the lower portion (LC) of the colon (C).
- trocar (330) is inserted through the line of staples (585) such that trocar (330) is exposed out of lower colon portion (LC).
- Anvil (400) is shown to be positioned in the upper portion (UC) of the colon (C), with shank (420) extending through an opening of the upper colon portion (UC).
- each end of the severed and stapled lower portion (LC) has been folded inwardly such that each outer magnet (552a) magnetically couples with the respective inner magnet (552b). Therefore, at least part of the lower colon portion (LC) is shown to be drawn radially inwardly toward trocar (330), such that the line of staples (585) lies within the cutting line of knife (340). In other words, the coupling of magnets (552a, 552b) with each other will effectively fold flap regions (FR) inwardly.
- the circular cutting line of knife member (340) is defined by the diameter (b) of knife member (340).
- the operator With magnets (552a, 552b) coupled together to secure flap regions (FR) in an inwardly folded configuration, the operator then connects shank (420) to trocar (330) in the manner discussed above. Alternatively, the operator may fold of flap regions (FR) inwardly to couple corresponding magnets (552a, 552b) together after shank (420) and trocar (330) are coupled to one another. Referring to FIG. 14B , the operator may then draw anvil (400) toward stapling head assembly (300), in the manner described above (e.g., utilizing knob (130)), thus also drawing the upper colon portion (UC) toward the lower colon portion (LC). The operator may then retract trocar (330) until the tissue of the upper colon portion (UC) and the lower colon portion (LC) are compressed against the deck member (320) to achieve a desirable gap distance, as shown in FIG. 14B and discussed above.
- the operator may then actuate trigger (150) to actuate stapling head assembly (300), resulting in the stapling and severing of tissue in a similar manner as shown in FIG. 9 to form an anastomosis (A).
- trigger (150) to actuate stapling head assembly (300), resulting in the stapling and severing of tissue in a similar manner as shown in FIG. 9 to form an anastomosis (A).
- all of the tissue in which staples (585) are applied is severed and no staples (585) are disposed in the tissue that remains at the resulting anastomosis (A) site as shown in FIG. 14C .
- staples (585) do not impede the successful operation of circular stapler (10), and there are no flap regions (FR) extending outwardly from the anastomosis (A) site.
- the severed portion of tissue including staples (585) may be removed by the user via the patient's rectum.
- FIGS. 15-16 show lower colon portion (LC) after endocutter stapler (1000) has been utilized to staple and sever a portion of lower colon portion (LC).
- staple line includes three rows of staples including two sections of outer staples (685a) and a section of inner staples (685b) between the outer staples (685b).
- outer staples (685a) are ferromagnetic and inner staples (685b) are non-ferromagnetic.
- the staple line may include a different number of staple rows, such as one or two, or more than three.
- outer staples (685a) are ferromagnetic, while three in the first row, four in the second row, and three in the third row of inner staples (685b) are non-ferromagnetic.
- outer staples (685a) may be comprised entirely of a ferromagnetic material.
- outer staples (685a) may be only partially comprised of a ferromagnetic material and partially of a non-ferromagnetic material. In such examples, some or all of outer staples (685a) may include a ferromagnetic core or portion that is coated with a non-ferromagnetic material. Additionally or alternatively, some or all of outer staples may include a non-ferromagnetic core or portion that is coated with a ferromagnetic material. Suitable other configurations of outer staples (685a) will be understood by persons skilled in the art in view of the teachings herein.
- ferromagnetic materials iron and alloys thereof, nickel and alloys thereof, etc.
- non-ferromagnetic materials e.g., titanium, stainless steel, cobalt chromium, etc.
- FIG. 16 shows a step of an anastomosis procedure similar to the steps shown in FIGS. 8 and 14A .
- upper colon portion (UC) and lower colon portion (LC) are shown to have been severed and stapled in a similar manner to that shown in FIGS. 7-8 and 14A-B .
- at least the lower colon portion (LC) has been severed and stapled utilizing a staple cartridge (e.g., staple cartridge (1140)) including staples (685a, 685b) configured to be implanted in tissue as shown in FIGS. 15 .
- Lower colon portion therefore includes staples (685a, 685b) coupled thereto in the manner discussed above.
- a portion of shaft (210) and stapling head assembly (300) are inserted into the rectum (R) of the patient and into the lower portion of the colon (C).
- the circular stapler of the present example includes a modified trocar (1330) that is substantially identical to trocar (330), except that trocar (1330) includes a permanent magnet (1331) embedded therein.
- magnet (1331) may be on a different portion of circular stapler (10), such as in a different part of stapling head assembly (300).
- magnet (1331) is a rare earth magnetic material such as samarium-cobalt, neodymium, etc.
- Other suitable materials that magnet (1331) may comprise will be apparent to persons skilled in the art in view of the teachings herein.
- magnet (1331) may comprise an electromagnet. This may enable the operator to selectively activate magnet (1331) to generate a magnetic field at the appropriate time during the surgical procedure (e.g., by manipulating an activation input feature on handle assembly (100), etc.).
- magnets (552) of buttress (550) described above may comprise electromagnets that are capable of selective activation in any suitable way as will be apparent to those of ordinary skill in the art in view of the teachings herein.
- trocar (1330) is inserted through the line of inner staples (685b) such that trocar (1330) is exposed out of lower colon portion (LC).
- Anvil (400) is shown to be positioned in the upper portion (UC) of the colon (C), with shank (420) extending through an opening of the upper colon portion (UC).
- outer staples (685a) are attracted to magnet (1331), drawing outer flap regions (FR) of lower colon portion (LC) radially inwardly toward trocar (1330), such that the severed tissue at the end of lower colon portion (LC) defines a width (d) that is smaller than the diameter (b) of knife member (340).
- the magnetic attraction between staples (685a) and magnet (1331) may be at a level such that upon trocar (1330) being inserted through line of inner staples (685b), staples (685a) are automatically magnetically drawn toward magnet (1331). In some instances, however, the operator may grasp the tissue at flap regions (FR) or otherwise manipulate the tissue at flap regions (FR) and thereby urge staples (685a) toward magnet (1331) until staples (685a) and magnet (1331) are magnetically coupled.
- staples (685a) are coupled with magnet (1331) and thereby hold all of the applied staples (685a, 685b) and all of the tissue at the severed end of lower colon portion (LC) in position within a cylindrical plane defined by knife member (340), the operator connects shank (420) to trocar (1330) in the manner discussed above.
- the operator may connect shank (420) to trocar (1330) after staples (685a) are magnetically coupled to magnet (1331).
- the operator may then draw anvil (400) toward stapling head assembly (300), in the manner described above (e.g., utilizing knob (130)), thus also drawing the upper colon portion (UC) toward the lower colon portion (LC).
- the operator may then retract trocar (1330) until the tissue of the upper colon portion (UC) and the lower colon portion (LC) are compressed against the deck member (320) to achieve a desirable gap distance, in a similar manner as shown in FIG. 15B .
- the operator may then actuate trigger (150) to actuate stapling head assembly (300), resulting in the stapling and severing of tissue in a similar manner as shown in FIG. 9 .
- trigger (150) to actuate stapling head assembly (300), resulting in the stapling and severing of tissue in a similar manner as shown in FIG. 9 .
- all of the tissue in which staples (685a, 685b) are applied is severed and no staples (685a, 685b) are disposed in the tissue that remains at the resulting anastomosis site.
- staples (685a, 685b) do not impede the successful operation of circular stapler (10), and there are no flap regions (FR) extending outwardly from the anastomosis site.
- the severed portion of tissue including staples (685a, 685b) may be removed by the user via the patient's rectum.
- An apparatus comprising a staple cartridge, wherein the staple cartridge comprises: (i) a plurality of staples, (ii) a deck, wherein the deck defines a plurality of openings, wherein each opening of the plurality of openings is associated with a corresponding staple of the plurality of staples, such that each staple is configured to pass through a corresponding opening of the plurality of openings, and (iii) a magnetic feature, wherein the magnetic feature is configured to be coupled to tissue in response to actuation of the staple cartridge, wherein the magnetic feature is configured to retain at least one outer portion of stapled tissue in an inwardly folded position relative to an inner portion of stapled tissue.
- Example 1 The apparatus of Example 1, wherein the staple cartridge further comprises a buttress, wherein the magnetic feature is positioned on the buttress.
- Example 2 wherein the magnetic feature comprises a plurality of magnets embedded in the buttress
- Example 4 The apparatus of Example 4, wherein the magnets are positioned on one or both of a top portion or a bottom portion of the buttress.
- the magnetic feature comprises an inner magnet and an outer magnet secured to the buttress, wherein the outer magnet is configured to magnetically couple to the inner magnet in response to the at least one outer portion of stapled tissue being folded inwardly toward the inner portion of stapled tissue.
- Example 8 wherein the buttress comprises a first pair of inner and outer magnets at one end of the buttress and a second pair of inner and outer magnets at another end of the buttress.
- the staples comprise an inner portion of staples between two opposing outer portions of staples, wherein the outer staples comprise a ferromagnetic material to form the magnetic feature.
- Example 11 The apparatus of Example 11, wherein the inner staples consist essentially of a non-ferromagnetic material.
- the circular stapler comprises: (i) an anvil, and (ii) a stapling head assembly, wherein the stapling head assembly comprises: (A) a rod configured to engage the anvil, (B) a knife member configured to form a circular cut line in tissue, and (C) a staple driver, wherein the anvil and stapling head assembly are configured to cooperate to clamp and staple tissue; wherein the magnetic feature is configured to magnetically couple to
- Example 13 wherein the magnetic feature is configured to magnetically couple to the rod of the circular stapler.
- a method of operating on tissue using a circular stapler wherein the circular stapler comprises an anvil, and a stapling head assembly, wherein the stapling head assembly includes a rod, a knife member, and a staple driver, wherein the knife member is configured to provide a circular cut line, wherein the anvil and the stapling head assembly are configured to cooperate to clamp and staple tissue
- the method comprises: (a) severing and stapling a first portion of anatomical structure using a non-circular stapler, thereby leaving a plurality of staples and a first magnetic feature on a severed end portion of the first portion of anatomical structure; (b) inserting the anvil of the circular stapler into a second portion of anatomical structure; (c) inserting the stapling head assembly into the first portion of anatomical structure until at least a portion of the rod extends past the severed end portion of the first portion of anatomical structure; (d) drawing the first magnetic feature inwardly toward the rod such that
- Example 17 The method of Example 17, wherein the first and second magnetic features are disposed on a buttress associated with the non-circular stapler.
- a method of operating on tissue using a circular stapler wherein the circular stapler comprises an anvil, and a stapling head assembly, wherein the stapling head assembly includes a rod, a knife member, and a staple driver, wherein the knife member is configured to provide a circular cut line, wherein the anvil and the stapling head assembly are configured to cooperate to clamp and staple tissue
- the method comprises: (a) severing and stapling a first portion of the colon using a non-circular stapler, thereby leaving a first plurality of staples and a first magnetic feature on a first severed end portion of the first portion of the colon; (b) severing and stapling a second portion of the colon using a non-circular stapler, thereby leaving a second plurality of staples on a second severed end portion of the second portion of the colon; (c) inserting the anvil of the circular stapler into the second portion of the colon; (d) inserting the stapling head assembly into
- Versions of the devices described above may have application in conventional medical treatments and procedures conducted by a medical professional, as well as application in robotic-assisted medical treatments and procedures.
- various teachings herein may be readily incorporated into a robotic surgical system such as the DAVINCITM system by Intuitive Surgical, Inc., of Sunnyvale, California.
- Versions described above may be designed to be disposed of after a single use, or they can be designed to be used multiple times. Versions may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, some versions of the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, some versions of the device may be reassembled for subsequent use either at a reconditioning facility, or by a user immediately prior to a procedure.
- reconditioning of a device may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.
- versions described herein may be sterilized before and/or after a procedure.
- the device is placed in a closed and sealed container, such as a plastic or TYVEK bag.
- the container and device may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons.
- the radiation may kill bacteria on the device and in the container.
- the sterilized device may then be stored in the sterile container for later use.
- a device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US14/864,050 US9987013B2 (en) | 2015-09-24 | 2015-09-24 | Surgical staple buttress with magnetic elements |
Publications (1)
Publication Number | Publication Date |
---|---|
EP3146909A1 true EP3146909A1 (de) | 2017-03-29 |
Family
ID=56990363
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP16190430.5A Withdrawn EP3146909A1 (de) | 2015-09-24 | 2016-09-23 | Chirurgische klammerversteifung mit magnetischen elementen |
Country Status (6)
Country | Link |
---|---|
US (1) | US9987013B2 (de) |
EP (1) | EP3146909A1 (de) |
JP (1) | JP6903643B2 (de) |
CN (1) | CN108024811B (de) |
BR (1) | BR112018005758B1 (de) |
WO (1) | WO2017053189A1 (de) |
Families Citing this family (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10492790B2 (en) * | 2015-09-24 | 2019-12-03 | Ethicon Llc | Apparatus and method for cinching a straight staple line |
USD833010S1 (en) * | 2017-02-17 | 2018-11-06 | Ethicon Llc | Stapling head feature for a surgical stapler |
WO2019041315A1 (en) | 2017-09-01 | 2019-03-07 | Covidien Lp | CIRCULAR STAPLING DEVICE WITH POSITIONING RIBS |
US11147560B2 (en) * | 2018-11-07 | 2021-10-19 | Covidien Lp | Buttress for circular EEA staplers |
US11944310B2 (en) | 2021-08-13 | 2024-04-02 | Cilag Gmbh International | Non-circular end effector features for surgical stapler |
US11911039B2 (en) | 2021-08-13 | 2024-02-27 | Cilag Gmbh International | Circular surgical stapler having staples with expandable crowns |
US20230049352A1 (en) * | 2021-08-13 | 2023-02-16 | Cilag Gmbh International | Circular surgical stapler end effector having staple line alignment feature |
Citations (38)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4805823A (en) | 1988-03-18 | 1989-02-21 | Ethicon, Inc. | Pocket configuration for internal organ staplers |
EP0326757A1 (de) * | 1988-02-05 | 1989-08-09 | Tatsuo Fujitsuka | Vorrichtung zur Anastomose des Verdauungssystems |
US5205459A (en) | 1991-08-23 | 1993-04-27 | Ethicon, Inc. | Surgical anastomosis stapling instrument |
US5333773A (en) | 1991-08-23 | 1994-08-02 | Ethicon, Inc. | Sealing means for endoscopic surgical anastomosis stapling instrument |
US5350104A (en) | 1991-08-23 | 1994-09-27 | Ethicon, Inc. | Sealing means for endoscopic surgical anastomosis stapling instrument |
US5415334A (en) | 1993-05-05 | 1995-05-16 | Ethicon Endo-Surgery | Surgical stapler and staple cartridge |
US5465895A (en) | 1994-02-03 | 1995-11-14 | Ethicon Endo-Surgery, Inc. | Surgical stapler instrument |
US5597107A (en) | 1994-02-03 | 1997-01-28 | Ethicon Endo-Surgery, Inc. | Surgical stapler instrument |
US5632432A (en) | 1994-12-19 | 1997-05-27 | Ethicon Endo-Surgery, Inc. | Surgical instrument |
US5704534A (en) | 1994-12-19 | 1998-01-06 | Ethicon Endo-Surgery, Inc. | Articulation assembly for surgical instruments |
US5814055A (en) | 1995-09-19 | 1998-09-29 | Ethicon Endo-Surgery, Inc. | Surgical clamping mechanism |
US6978921B2 (en) | 2003-05-20 | 2005-12-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating an E-beam firing mechanism |
US7143923B2 (en) | 2003-05-20 | 2006-12-05 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a firing lockout for an unclosed anvil |
US7303108B2 (en) | 2003-09-29 | 2007-12-04 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating a multi-stroke firing mechanism with a flexible rack |
US7367485B2 (en) | 2004-06-30 | 2008-05-06 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating a multistroke firing mechanism having a rotary transmission |
US7380696B2 (en) | 2003-05-20 | 2008-06-03 | Ethicon Endo-Surgery, Inc. | Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism |
US7380695B2 (en) | 2003-05-20 | 2008-06-03 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a single lockout mechanism for prevention of firing |
US7404508B2 (en) | 2005-07-26 | 2008-07-29 | Ethicon Endo-Surgery, Inc. | Surgical stapling and cutting device |
US7434715B2 (en) | 2003-09-29 | 2008-10-14 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having multistroke firing with opening lockout |
US7721930B2 (en) | 2006-11-10 | 2010-05-25 | Thicon Endo-Surgery, Inc. | Disposable cartridge with adhesive for use with a stapling device |
US7794475B2 (en) | 2006-09-29 | 2010-09-14 | Ethicon Endo-Surgery, Inc. | Surgical staples having compressible or crushable members for securing tissue therein and stapling instruments for deploying the same |
US20100264193A1 (en) | 2007-06-22 | 2010-10-21 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
US20120116379A1 (en) | 2010-11-05 | 2012-05-10 | Yates David C | Motor Driven Electrosurgical Device With Mechanical And Electrical Feedback |
US20120239012A1 (en) | 2009-12-24 | 2012-09-20 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
EP2687165A1 (de) * | 2012-07-18 | 2014-01-22 | Covidien LP | Chirurgische Vorrichtung, die eine chirurgische Versteifung enthält |
US20140144968A1 (en) | 2012-11-29 | 2014-05-29 | Ethicon Endo-Surgery, Inc. | Surgical staple with integral pledget for tip deflection |
US20140144969A1 (en) | 2012-11-29 | 2014-05-29 | Ethicon Endo-Surgery, Inc. | Pivoting anvil for surgical circular stapler |
US20140151430A1 (en) | 2012-12-04 | 2014-06-05 | Ethicon Endo-Surgery, Inc. | Circular anvil introduction system with alignment feature |
US20140151429A1 (en) | 2012-12-04 | 2014-06-05 | Ethicon Endo-Surgery, Inc. | Trans-oral circular anvil introduction system with dilation feature |
US20140158747A1 (en) | 2012-12-06 | 2014-06-12 | Ethicon Endo-Surgery, Inc. | Surgical stapler with varying staple widths along different circumferences |
US20140166717A1 (en) | 2012-12-17 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Circular stapler with selectable motorized and manual control, including a control ring |
US20140166718A1 (en) | 2012-12-17 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Motor driven rotary input circular stapler with lockable flexible shaft |
US20140166728A1 (en) | 2012-12-17 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Motor driven rotary input circular stapler with modular end effector |
US8910847B2 (en) | 2011-05-19 | 2014-12-16 | Ethicon Endo-Surgery, Inc. | Low cost anvil assembly for a circular stapler |
US20150083774A1 (en) | 2013-09-23 | 2015-03-26 | Ethicon Endo-Surgery, Inc. | Control features for motorized surgical stapling instrument |
US20150083775A1 (en) | 2013-09-23 | 2015-03-26 | Ethicon Endo-Surgery, Inc. | Surgical stapler with rotary cam drive |
US20150083773A1 (en) | 2013-09-23 | 2015-03-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with drive assembly having toggle features |
US20150083772A1 (en) | 2013-09-23 | 2015-03-26 | Ethicon Endo-Surgery, Inc. | Surgical stapler with rotary cam drive and return |
Family Cites Families (29)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPH01297055A (ja) * | 1988-02-05 | 1989-11-30 | Tatsuo Fujitsuka | 吻合器 |
US5330486A (en) * | 1992-07-29 | 1994-07-19 | Wilk Peter J | Laparoscopic or endoscopic anastomosis technique and associated instruments |
CA2124109A1 (en) * | 1993-05-24 | 1994-11-25 | Mark T. Byrne | Endoscopic surgical instrument with electromagnetic sensor |
US5957430A (en) * | 1996-10-28 | 1999-09-28 | Olson; Rory | Magnetized staple remover |
US8784482B2 (en) * | 2000-09-20 | 2014-07-22 | Mvrx, Inc. | Method of reshaping a heart valve annulus using an intravascular device |
US20050131390A1 (en) * | 2002-04-25 | 2005-06-16 | Russell Heinrich | Surgical instruments including mems devices |
US7914543B2 (en) * | 2003-10-14 | 2011-03-29 | Satiety, Inc. | Single fold device for tissue fixation |
US20090090763A1 (en) * | 2007-10-05 | 2009-04-09 | Tyco Healthcare Group Lp | Powered surgical stapling device |
US20050251189A1 (en) * | 2004-05-07 | 2005-11-10 | Usgi Medical Inc. | Multi-position tissue manipulation assembly |
WO2006014881A2 (en) * | 2004-07-26 | 2006-02-09 | Van Lue Stephen J | Surgical stapler with magnetically secured components |
US9463012B2 (en) * | 2004-10-26 | 2016-10-11 | P Tech, Llc | Apparatus for guiding and positioning an implant |
US7837080B2 (en) * | 2008-09-18 | 2010-11-23 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with device for indicating when the instrument has cut through tissue |
US8801735B2 (en) * | 2010-07-30 | 2014-08-12 | Ethicon Endo-Surgery, Inc. | Surgical circular stapler with tissue retention arrangements |
US20120080498A1 (en) * | 2010-09-30 | 2012-04-05 | Ethicon Endo-Surgery, Inc. | Curved end effector for a stapling instrument |
US9649113B2 (en) * | 2011-04-27 | 2017-05-16 | Covidien Lp | Device for monitoring physiological parameters in vivo |
US9101359B2 (en) * | 2011-09-13 | 2015-08-11 | Ethicon Endo-Surgery, Inc. | Surgical staple cartridge with self-dispensing staple buttress |
WO2013096873A1 (en) * | 2011-12-22 | 2013-06-27 | Modular Bionics Inc. | Neural interface device and insertion tools |
US9345481B2 (en) * | 2013-03-13 | 2016-05-24 | Ethicon Endo-Surgery, Llc | Staple cartridge tissue thickness sensor system |
EP4079242A1 (de) * | 2013-03-19 | 2022-10-26 | Surgisense Corporation | Vorrichtung, systeme und verfahren zur bestimmung der sauerstoffanreicherung von gewebe |
US9642642B2 (en) * | 2013-09-20 | 2017-05-09 | Kok Hoo LIM | Guide tip introducer and method to create thereof |
US10478189B2 (en) * | 2015-06-26 | 2019-11-19 | Ethicon Llc | Method of applying an annular array of staples to tissue |
US9907600B2 (en) * | 2013-11-15 | 2018-03-06 | Ethicon Llc | Ultrasonic anastomosis instrument with piezoelectric sealing head |
US10188386B2 (en) * | 2015-06-26 | 2019-01-29 | Ethicon Llc | Surgical stapler with anvil state indicator |
US10405855B2 (en) * | 2015-06-26 | 2019-09-10 | Ethicon Llc | Firing circuit for surgical stapler |
US10194911B2 (en) * | 2015-06-26 | 2019-02-05 | Ethicon Llc | Surgical stapler with ready state indicator |
US10905415B2 (en) * | 2015-06-26 | 2021-02-02 | Ethicon Llc | Surgical stapler with electromechanical lockout |
US10456134B2 (en) | 2015-06-26 | 2019-10-29 | Ethicon Llc | Surgical stapler with reversible motor |
US10265066B2 (en) * | 2015-06-26 | 2019-04-23 | Ethicon Llc | Surgical stapler with incomplete firing indicator |
US10271842B2 (en) | 2015-06-26 | 2019-04-30 | Ethicon Llc | Anvil stabilization features for surgical stapler |
-
2015
- 2015-09-24 US US14/864,050 patent/US9987013B2/en active Active
-
2016
- 2016-09-16 JP JP2018515648A patent/JP6903643B2/ja active Active
- 2016-09-16 BR BR112018005758-4A patent/BR112018005758B1/pt active IP Right Grant
- 2016-09-16 WO PCT/US2016/052108 patent/WO2017053189A1/en active Application Filing
- 2016-09-16 CN CN201680055746.XA patent/CN108024811B/zh active Active
- 2016-09-23 EP EP16190430.5A patent/EP3146909A1/de not_active Withdrawn
Patent Citations (48)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0326757A1 (de) * | 1988-02-05 | 1989-08-09 | Tatsuo Fujitsuka | Vorrichtung zur Anastomose des Verdauungssystems |
US4805823A (en) | 1988-03-18 | 1989-02-21 | Ethicon, Inc. | Pocket configuration for internal organ staplers |
US5533661A (en) | 1991-08-23 | 1996-07-09 | Ethicon, Inc. | Sealing means for endoscopic surgical anastomosis stapling instrument |
US5205459A (en) | 1991-08-23 | 1993-04-27 | Ethicon, Inc. | Surgical anastomosis stapling instrument |
US5271544A (en) | 1991-08-23 | 1993-12-21 | Ethicon, Inc. | Surgical anastomosis stapling instrument |
US5275322A (en) | 1991-08-23 | 1994-01-04 | Ethicon, Inc. | Surgical anastomosis stapling instrument |
US5285945A (en) | 1991-08-23 | 1994-02-15 | Ethicon, Inc. | Surgical anastomosis stapling instrument |
US5292053A (en) | 1991-08-23 | 1994-03-08 | Ethicon, Inc. | Surgical anastomosis stapling instrument |
US5333773A (en) | 1991-08-23 | 1994-08-02 | Ethicon, Inc. | Sealing means for endoscopic surgical anastomosis stapling instrument |
US5350104A (en) | 1991-08-23 | 1994-09-27 | Ethicon, Inc. | Sealing means for endoscopic surgical anastomosis stapling instrument |
US5415334A (en) | 1993-05-05 | 1995-05-16 | Ethicon Endo-Surgery | Surgical stapler and staple cartridge |
US5597107A (en) | 1994-02-03 | 1997-01-28 | Ethicon Endo-Surgery, Inc. | Surgical stapler instrument |
US5465895A (en) | 1994-02-03 | 1995-11-14 | Ethicon Endo-Surgery, Inc. | Surgical stapler instrument |
US5632432A (en) | 1994-12-19 | 1997-05-27 | Ethicon Endo-Surgery, Inc. | Surgical instrument |
US5673840A (en) | 1994-12-19 | 1997-10-07 | Ethicon Endo-Surgery, Inc. | Surgical instrument |
US5704534A (en) | 1994-12-19 | 1998-01-06 | Ethicon Endo-Surgery, Inc. | Articulation assembly for surgical instruments |
US5814055A (en) | 1995-09-19 | 1998-09-29 | Ethicon Endo-Surgery, Inc. | Surgical clamping mechanism |
US7000818B2 (en) | 2003-05-20 | 2006-02-21 | Ethicon, Endo-Surger, Inc. | Surgical stapling instrument having separate distinct closing and firing systems |
US7143923B2 (en) | 2003-05-20 | 2006-12-05 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a firing lockout for an unclosed anvil |
US7380696B2 (en) | 2003-05-20 | 2008-06-03 | Ethicon Endo-Surgery, Inc. | Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism |
US7380695B2 (en) | 2003-05-20 | 2008-06-03 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a single lockout mechanism for prevention of firing |
US6978921B2 (en) | 2003-05-20 | 2005-12-27 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating an E-beam firing mechanism |
US7434715B2 (en) | 2003-09-29 | 2008-10-14 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having multistroke firing with opening lockout |
US7303108B2 (en) | 2003-09-29 | 2007-12-04 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating a multi-stroke firing mechanism with a flexible rack |
US7367485B2 (en) | 2004-06-30 | 2008-05-06 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument incorporating a multistroke firing mechanism having a rotary transmission |
US7404508B2 (en) | 2005-07-26 | 2008-07-29 | Ethicon Endo-Surgery, Inc. | Surgical stapling and cutting device |
US7794475B2 (en) | 2006-09-29 | 2010-09-14 | Ethicon Endo-Surgery, Inc. | Surgical staples having compressible or crushable members for securing tissue therein and stapling instruments for deploying the same |
US7721930B2 (en) | 2006-11-10 | 2010-05-25 | Thicon Endo-Surgery, Inc. | Disposable cartridge with adhesive for use with a stapling device |
US20100264193A1 (en) | 2007-06-22 | 2010-10-21 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
US8408439B2 (en) | 2007-06-22 | 2013-04-02 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
US20130168435A1 (en) | 2007-06-22 | 2013-07-04 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an articulatable end effector |
US20120239012A1 (en) | 2009-12-24 | 2012-09-20 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
US8453914B2 (en) | 2009-12-24 | 2013-06-04 | Ethicon Endo-Surgery, Inc. | Motor-driven surgical cutting instrument with electric actuator directional control assembly |
US20120116379A1 (en) | 2010-11-05 | 2012-05-10 | Yates David C | Motor Driven Electrosurgical Device With Mechanical And Electrical Feedback |
US8910847B2 (en) | 2011-05-19 | 2014-12-16 | Ethicon Endo-Surgery, Inc. | Low cost anvil assembly for a circular stapler |
EP2687165A1 (de) * | 2012-07-18 | 2014-01-22 | Covidien LP | Chirurgische Vorrichtung, die eine chirurgische Versteifung enthält |
US20140144969A1 (en) | 2012-11-29 | 2014-05-29 | Ethicon Endo-Surgery, Inc. | Pivoting anvil for surgical circular stapler |
US20140144968A1 (en) | 2012-11-29 | 2014-05-29 | Ethicon Endo-Surgery, Inc. | Surgical staple with integral pledget for tip deflection |
US20140151430A1 (en) | 2012-12-04 | 2014-06-05 | Ethicon Endo-Surgery, Inc. | Circular anvil introduction system with alignment feature |
US20140151429A1 (en) | 2012-12-04 | 2014-06-05 | Ethicon Endo-Surgery, Inc. | Trans-oral circular anvil introduction system with dilation feature |
US20140158747A1 (en) | 2012-12-06 | 2014-06-12 | Ethicon Endo-Surgery, Inc. | Surgical stapler with varying staple widths along different circumferences |
US20140166717A1 (en) | 2012-12-17 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Circular stapler with selectable motorized and manual control, including a control ring |
US20140166718A1 (en) | 2012-12-17 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Motor driven rotary input circular stapler with lockable flexible shaft |
US20140166728A1 (en) | 2012-12-17 | 2014-06-19 | Ethicon Endo-Surgery, Inc. | Motor driven rotary input circular stapler with modular end effector |
US20150083774A1 (en) | 2013-09-23 | 2015-03-26 | Ethicon Endo-Surgery, Inc. | Control features for motorized surgical stapling instrument |
US20150083775A1 (en) | 2013-09-23 | 2015-03-26 | Ethicon Endo-Surgery, Inc. | Surgical stapler with rotary cam drive |
US20150083773A1 (en) | 2013-09-23 | 2015-03-26 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with drive assembly having toggle features |
US20150083772A1 (en) | 2013-09-23 | 2015-03-26 | Ethicon Endo-Surgery, Inc. | Surgical stapler with rotary cam drive and return |
Also Published As
Publication number | Publication date |
---|---|
CN108024811A (zh) | 2018-05-11 |
CN108024811B (zh) | 2021-02-26 |
US20170086833A1 (en) | 2017-03-30 |
WO2017053189A1 (en) | 2017-03-30 |
JP2018532478A (ja) | 2018-11-08 |
BR112018005758A2 (pt) | 2018-10-09 |
JP6903643B2 (ja) | 2021-07-14 |
US9987013B2 (en) | 2018-06-05 |
BR112018005758B1 (pt) | 2023-04-18 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US11510676B2 (en) | Apparatus and method for cinching a straight staple line | |
US20210169488A1 (en) | Pivoting anvil for surgical circular stapler | |
EP3146917B1 (de) | Vorrichtung zur faltung eines körperlumens | |
US9987013B2 (en) | Surgical staple buttress with magnetic elements | |
EP3320858B1 (de) | Ringförmiges, chirurgisches klammergerät mit versenktem verdeck | |
EP3320859A1 (de) | Ringförmiges, chirurgisches klammergerät mit winkelig asymmetrischen verdecksmerkmalen | |
EP3146910B1 (de) | Vorrichtung zur formung einer klammerreihe mit trokar-durchgang | |
EP3146913B1 (de) | Vorrichtung zur radialen bündelung eines körperlumens |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
PUAI | Public reference made under article 153(3) epc to a published international application that has entered the european phase |
Free format text: ORIGINAL CODE: 0009012 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: THE APPLICATION HAS BEEN PUBLISHED |
|
AK | Designated contracting states |
Kind code of ref document: A1 Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR |
|
AX | Request for extension of the european patent |
Extension state: BA ME |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: REQUEST FOR EXAMINATION WAS MADE |
|
17P | Request for examination filed |
Effective date: 20170825 |
|
RAX | Requested extension states of the european patent have changed |
Extension state: BA Payment date: 20170825 Extension state: ME Payment date: 20170825 |
|
RBV | Designated contracting states (corrected) |
Designated state(s): AL AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: EXAMINATION IS IN PROGRESS |
|
17Q | First examination report despatched |
Effective date: 20190327 |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: EXAMINATION IS IN PROGRESS |
|
RAP3 | Party data changed (applicant data changed or rights of an application transferred) |
Owner name: ETHICON LLC |
|
RAP3 | Party data changed (applicant data changed or rights of an application transferred) |
Owner name: ETHICON LLC |
|
STAA | Information on the status of an ep patent application or granted ep patent |
Free format text: STATUS: THE APPLICATION IS DEEMED TO BE WITHDRAWN |
|
18D | Application deemed to be withdrawn |
Effective date: 20230711 |